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The Johns Hopkins Hospital, 600 N Wolfe St, Tower 711, Baltimore, MD 21287
(Email: chogue2@jhmi.edu).
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Maekawa and colleagues [1] report the findings from a study of 247 patients who underwent brain diffusion-weighted magnetic resonance imaging (DWI) prior to elective cardiac surgery. The method of DWI is a sensitive way to detect acute brain ischemic injury and to distinguish new from chronic brain lesions. The findings of this study adds to a growing appreciation of the rising frequency of cerebral vascular disease and brain infarction in patients before cardiac surgery. Indeed multiple studies have shown the frequency of pre-existing cerebral infarcts to be as high as 45% in patients scheduled for cardiac surgery. In most instances, these lesions are clinically asymptomatic and thus they go undetected in the absence of brain
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